EPIC-Norfolk is a population-based prospective cohort study which is led jointly by Professor KT Khaw (Clinical Gerontology Unit, University of Cambridge) and Professor Nick Wareham (MRC Epidemiology Unit). Current core study co-ordination and data management is funded by a MRC Programme Grant (leads, KT Khaw and Nick Wareham) with the Unit providing support for sample storage and analysis. The Unit currently supports a 4th Health Check of the cohort participants, the focus of which is on objective quantification of physical activity and body composition in this ageing population. EPIC-Norfolk is one of the two UK contributing cohorts to the EPIC-Europe study.

Study Summary

The EPIC-Norfolk study is a prospective population-based cohort study which recruited 25,000 men and women aged 40-79 years at baseline between 1993 and 1997 from 35 participating general practices in Norfolk. Individuals provided information about lifestyle behavioural factors including diet and activity and attended for a baseline health check including the provision of blood samples for concurrent and future analysis. They provided consent to future linkage to medical record information and a wide range of follow-up studies for different disease endpoints (including incident T2DM) have subsequently been undertaken (see www.srl.cam.ac.uk/epic). From 1998, participants were re-invited to attend a second health check at which baseline measures were repeated and additional measurements were added including ultrasound measurement of heel bone density and impedance assessment of total body fat. Between 2006 and 2011 a third health check was completed in which the focus of attention was on functional capacity with assessment of cognition, visual function and physical performance. A fourth health check is currently underway in which assessments of functional capacity are being repeated (grip strength, balance test, gait speed and chair stand) together with objective measurement of body composition including lean muscle mass by DEXA and physical activity and sedentary behaviour by accelerometry (Actigraph).

DNA has been extracted from all EPIC participants and stored blood has been analysed for an extensive range of classical and novel biomarkers including measures of inflammation, sex hormones and nutrition (e.g. plasma vitamins C, and D, and carotenoids). A genomewide association study was originally conducted with EPIC-Norfolk in a case-cohort study design for obesity (N= 3552) including a random sub-cohort of 2417 individuals and 1135 obese people. The GWAS coverage is now being expanded to the entire EPIC Norfolk cohort funded by MRC.

Status

Actively recruiting participants for the 4th health check. Recruited over 2000 participants as of March 2014 and this is expected to double by the end of the year

Unit role

Unit led in collaboration with the Clinical Gerontology Unit, University of Cambridge

Funding

The 4th health check (EPIC-4) is funded by MRC core (set up of the Norwich field station, including dexa scanner and data collection) with funding for data management provided by an MRC programme grant (Co-Investigators, Professor Kay Tee Khaw and Professor Nick Wareham). Clinical Gerontology is currently responsible for the data. The Unit funds and is responsible for samples (all health checks). Funding for the extension of the GWAS analysis to cover the entire cohort was funded by the MRC Omics call (Unit held, MC_PC_13048).